Myocardial injury after noncardiac surgery—incidence and predictors from a prospective observational cohort study at an Indian tertiary care centre

George, Rubin; Menon, Vidya; Edathadathil, Fabia; Balachandran, Sabarish; Moni, Merlin; Sathyapalan, Dipu T.; Prasanna, Preetha; Gokuldas, S; Paul, Jerry; Chandrababu, K K; Kumar, Lakshmi; Pillai, Anju S.

doi:10.1097/md.0000000000010402

Cited by 25 publications

(42 citation statements)

References 15 publications

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“…). Following assessment, 68 articles, involving 708 032 patients across 71 LMICs, were included in the review ( Tables S1 and S2 , supporting information). Country‐specific patient numbers were reported in 60 studies but were absent from six and two provided total LMIC patient numbers only.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Knight

Ots

Maimbo

et al. 2019

British Journal of Surgery

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Background Technological advances have led to the generation of large amounts of data, both in surgical research and practice. Despite this, it is unclear how much originates in low‐ and middle‐income countries (LMICs) and what barriers exist to the use of such data in improving surgical care. The aim of this review was to capture the extent and impact of programmes that use large volumes of patient data on surgical care in LMICs. Methods A PRISMA‐compliant systematic literature review of PubMed, Embase and Google Scholar was performed in August 2018. Prospective studies collecting large volumes of patient‐level data within LMIC settings were included and evaluated qualitatively. Results A total of 68 studies were included from 71 LMICs, involving 708 032 patients. The number of patients in included studies varied widely (from 335 to 428 346), with 25 reporting data on 3000 or more LMIC patients. Patient inclusion in large‐data studies in LMICs has increased dramatically since 2015. Studies predominantly involved Brazil, China, India and Thailand, with low patient numbers from Africa and Latin America. Outcomes after surgery were commonly the focus (33 studies); very few large studies looked at access to surgical care or patient expenditure. The use of large data sets specifically to improve surgical outcomes in LMICs is currently limited. Conclusion Large volumes of data are becoming more common and provide a strong foundation for continuing investigation. Future studies should address questions more specific to surgery.

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Section: Resultsmentioning

confidence: 99%

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Knight

Ots

Maimbo

et al. 2019

British Journal of Surgery

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“…An observational study by George et al showed that preoperative aspirin and statins reduce the risk of developing MINS and mortality rate. (6) All the three major guidelines recommend continuing statin therapy in the perioperative period (Class I recommendation, Level C evidence). (12)(13)(14) The ESC/ESA (12) and ACC/AHA (13) guidelines also recommend initiating statins in patients undergoing vascular surgery (Class IIa, Level B evidence).…”

Section: Preventionmentioning

confidence: 99%

“…(1) Since the VISION trial, there have been numerous other studies that substantiated this finding, emphasising the role of routine troponin measurements in surgical patients to enable further perioperative risk stratification and optimisation. (5)(6)(7) A large proportion of patients with MINS are asymptomatic. (5,6) Based on the estimated incremental cost per health gain, utilisation of perioperative troponin monitoring seems to be an attractive proposition, especially in high-risk patients.…”

Section: Introductionmentioning

confidence: 99%

“…(5)(6)(7) A large proportion of patients with MINS are asymptomatic. (5,6) Based on the estimated incremental cost per health gain, utilisation of perioperative troponin monitoring seems to be an attractive proposition, especially in high-risk patients. (8) There are no studies to show that perioperative troponin monitoring is counterproductive.…”

Section: Introductionmentioning

confidence: 99%

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Myocardial injury in non-cardiac surgery: complexities and challenges

Kuthiah

2020

smedj

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The term MINS (myocardial injury after non-cardiac surgery) was coined to broadly describe perioperative troponin elevation that is deemed to be due to a cardiac cause. However, this term is commonly used in literature to represent cases that do not fulfil the criteria for the diagnosis of myocardial infarction. Asymptomatic troponin elevation that does not fulfil the criteria for acute coronary syndrome in the perioperative setting has been shown to be associated with increased mortality. The discovery of MINS presents new opportunities to improve outcomes for surgical patients. Unfortunately, awareness of MINS among practitioners remains low and implementation of perioperative troponin monitoring is poor. Given its significance, the detection, management and prevention of MINS should not be overlooked.

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“…Зависимость частоты ПМВО от типа и объема вмешательства изучена недостаточно. Вероятно, неполостные операции осложняются реже (ортопедические -в 9,2% [22], на голове и шее -в 13% [23]). В то же время наибольшая частота ПМВО выявлена в абдоминальной (21%) и сосудис той (19,2-49,5%) хирургии [14,19,[23][24][25].…”

Section: определение критерии диагностики и распространенность пмвоunclassified

Myocardial injury after non-cardiac surgery: current state of the problem and unresolved issues

Протасов¹,

Большедворская²

2019

Russ J Cardiol

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В обзоре на основе данных литературы последнего десятилетия, рекомендаций международных и национальных профессиональных сообществ обобщены сведения о повреждении миокарда после внесердечных хирургических операций (ПМВО). Отражен растущий интерес к этой междисциплинарной проблеме, вызванный широкой распространенностью и тесной ассоциацией ПМВО со смертностью в послеоперационном периоде. Проанализированы наблюдательные исследования, посвященные поиску факторов риска и механизмов повреждения миокарда при хирургическом вмешательстве на других органах. Сделан акцент на роли бессимптомного повышения сердечных тропонинов, не уступающего по своей клинической и прогностической значимости послеоперационному инфаркту миокарда. Изложены современные подходы к диагностике и профилактике ПМВО. С учетом результатов недавно завершившегося первого рандомизированного контролируемого исследования MANAGE (2018) обсуждены возможности и перспективы лечения ПМВО. Определены нерешенные вопросы и направления дальнейших исследований в этой области. Ключевые слова: повреждение миокарда, внесердечные хирургические операции, тропонин. Конфликт интересов: не заявлен. 1 Иркутская государственная медицинская академия последипломного образования-филиал ФГБОУ ДПО Российская медицинская академия непрерывного профессионального образования Минздрава России, Иркутск;

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Myocardial injury after noncardiac surgery—incidence and predictors from a prospective observational cohort study at an Indian tertiary care centre

Abstract: Supplemental Digital Content is available in the text

Cited by 25 publications

References 15 publications

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Myocardial injury in non-cardiac surgery: complexities and challenges

Myocardial injury after non-cardiac surgery: current state of the problem and unresolved issues

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